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3 The Challenges of Aging – How older patients are different from all other patientsAs people age, some physiologic changes are inevitableOther changes, while not universal, are far more common than among younger peopleOlder people also face unique psycho-social challengesThese changes and challenges can lead to a variety of geriatric syndromes and issuesThese in turn can lead to poor health outcomes, functional decline, frailty, disability and dependence

5 Physiologic Changes Associated with AgingExamples of changes (including diseases) that are increasingly common, though not inevitable, as people ageHearing lossMacular degenerationHypertensionHeart diseaseCancerParkinson’s diseaseDementia

6 Social Problems More Common with AgingLoss of incomeLoss of close familyLoss of communitySocial isolation

8 The Challenges of an Aging Population – Why it mattersIn the 2000 US Census, 12.5% of the US population was >64By 2030, it is predicted that 20% of the US population will be >64As the elderly population increases the care needs and expenditures for that care will increaseThe geriatric workforce is not predicted to increase to meet this demand

9 Sensory Impairment - VisionVisual impairment affects 20-30% of people over the age of 75.Visual impairments that occur with greater frequency as people age includeRefractive errorCataractsGlaucomaMacular degenerationDiabetic retinopathyBlindness

15 Age Changes in PerformanceRefraction- lens and ciliary musclesResults in PresbyopiaAge 40+Acuity and ContrastDecreases after age 50Due to BrainGlare Due to lens and vitreous humorDarkPupil and Lens

29 GlaucomaWhat is it?A group of eye diseases that can damage the optic nerve in the eye.Glaucoma can develop in one or both eyes.Primary open-angle glaucoma is the most common form.

30 Who is at higher risk? African Americans over age 40.(continued from previous slide)Who is at higher risk?African Americans over age 40.Everyone over the age of 60, especially Mexican Americans.People with a family history of glaucoma.

31 GlaucomaNormal visionSame scene as viewed by a person with glaucoma

32 Glaucoma Symptoms Treatment options No early warning signs or symptomsNo painLoss of side visionTreatment optionsMedications, usually eye dropsLaser or conventional surgery

33 Glaucoma What can you do?People at higher risk should get a comprehensive dilated eye exam every one to two years or as instructed by your eye care professional.

35 Age-Related Macular Degeneration (AMD)What is it?Common among people aged 60 or older.Can damage the macula, which is needed for sharp, detailed central vision.

36 Who is at higher risk? The greatest risk factor is age.(continued from previous slide)Who is at higher risk?The greatest risk factor is age.Other risk factorsSmoking.Family history.Obesity.Race. Caucasians are more likely to lose vision from AMD.

42 Diabetic Eye Disease What is it?A group of eye problems associated with diabetes.Diabetic retinopathy is a leading cause of vision loss and blindness.

43 Who is at higher risk? People with diabetes.(continued from previous slide)Who is at higher risk?People with diabetes.The longer someone has diabetes, the more likely it is he or she will get diabetic retinopathy.

46 Diabetic Eye Disease What can you do?Control your ABCs - A1C, blood pressure, and cholesterol.Take your medications as directed.Maintain a healthy weight.Exercise.Don’t smoke.Have a dilated eye exam at least once a year.

47 Dry Eye What is it? The eye does not produce tears properly.Tears evaporate too quickly.Inflammation of the surface of the eye may occur along with dry eye.

48 Who is at higher risk? Women often experience dry eye more than men.(continued from previous slide)Who is at higher risk?Women often experience dry eye more than men.Dry eye can occur at any age.Older adults frequently experience dryness of the eyes.

49 Dry Eye Symptoms Stinging or burning of the eye.Feeling as if sand or grit is in the eye.Episodes of excess tears following dry eye periods.A stringy discharge from the eye.Pain and redness of the eye.Episodes of blurred vision.